An emaciated 18-year-old girl arrives at the ER. Her blood pressure（BP）is 70/45mmHg,her heart rate（HR）is 54, her potassium is 2.8,and her bicarbonate is 40 mEq/L.The gir＇s mother report that she has lost 35kg in three months but she is still convinced that she is overweight.She eats very small amounts of low-caloric food every day.What other activity is the patient likely to have engaged in

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